Comparing DSM-III-R and ICD-10 substance use disorders

At the present, the DSM-III-R is nearing the final stages of metamorphosis to DSM-IV. A series of field trials has been completed which has focused the attention on coverage of the different systems, the impact of social and legal problems on crossing the diagnostic threshold, the importance of subtyping by tolerance and withdrawal, the exclusionary diagnosis of abuse, the duration criterion, and other nosological comparisons. The focus of this Data Note is the comparison of rates between DSM-III, III-R, and both the old and new ICD-10 diagnostic systems, using data from the DSM-IV Substance Use Disorders Field Trials. Especially noteworthy is the inclusion of African Americans, females, and a population with a range of diagnoses and use patterns. Comparisons of DSM-III, III-R and ICD-10 substance use diagnoses among alcohol, nicotine, cannabis, cocaine substance users indicate considerable agreement for dependence but less similarities between systems for abuse and harmful use. These findings suggest that the dependence criteria may be more stable than those chosen to represent abuse and harmful use. More work needs to be done to evaluate the differences and similarities of the diagnostic systems.